Whose Limb Is It Anyway? - CASE STUDY

Kevin Wright came to Dr. Robert Smith, a general surgeon at Falkirk and District Infirmary in Scotland, with an unusual request. He wanted one of his legs to be amputated below the knee. Dr. Smith referred Mr. Wright, a teaching assistant from Essex, to the senior psychiatrist at Falkirk and District Royal Infirmary, Dr. George Dodds, for a psychiatric consultation. After meeting with Mr. Wright, Dr. Dodds said that he could not support the surgery and so advised Dr. Smith, the surgeon.

Despite Dr. Dodd's negative recommendation, and without further consultation, Dr. Smith amputated Mr. Wright's leg below the knee, as requested. Earlier in the year, Dr. Smith had carried out an amputation on a German citizen, Hans Schaub. In both cases there was no medical reason for amputating the limbs. The limbs were physically healthy and not diseased or deformed in any way. According to a report by Dr. Smith, Mr. Wright subsequently e-mailed him and said that he was very happy after having been in misery for thirty years. Dr. Smith admits that he does not understand the motivation of these patients: "It is a concept I still have difficulty in understanding," he said.

Although the operations were performed in National Health Service hospitals, the patients were private patients who paid the cost of the operation personally. Dr. Smith received no fee for the surgery.

When Dr. Smith revealed that he intended to perform a third amputation, this time on an American psychoanalyst (Greg Furth, a Jungian analyst in New York) who also wanted a healthy limb removed, the hospital board learned of his plans and refused him permission to perform the operation. At a news conference, Ian Mullen, a spokesperson for the hospital board said: "I don't believe it's appropriate for this type of operation to go ahead without consideration being given to the potential implications for the local reputation of the hospital and the concerns that might arise among the local population.